OK this is a fascinating trial, A RCT between low carb and low and found no major difference in Markers. Note they may have started as Keto but at the end they were having 40g of added sugar …
BUT this was being done in conjunctions with NUSI and this is Gary Taubes group so you can imagine the science was rigorous …
I would like to see Keto being measured but there is this fear it is ‘not possible;e’
Neither group was able to stick to the very low starting intakes: by month 3, the low-fat group was already consuming an average of 42 g of fat per day, whereas the low-carb group was consuming an average of 96.6 g of carbs per day.
Failed to pass the low-carb test to me.
If you’re strictly looking at this from a weight loss perspective, I think the study bares out what we know: different strategies work for different people.
If you’re looking to reverse Type 2 Diabetes, I think we know what strategy works here and which one does not.
KCKO
well some would say it is low carb compared to the average intake of 200g plus …
It is certainly NOT Keto
The study wasn’t valid for low-carb or low-fat dieting except in the first 2 weeks. Here, let me sum of the REAL findings:
If you require people to follow a diet for 2 weeks and then let them do what they want after, they will do what they want after. < sarcasm> WOW what a finding! < /sarcasm>
the problem is of course you can not force feed people, so I think it was rigorous as you can make it … Would be great if the guys could get Gary on to speak about it
You can’t force people, but you certainly can require them to follow the diet. This test is only valid to determine what happens if you explicitly allow people deviate from a diet. If you want to test for a variable, you need to isolate it. In this case, the variable was whether people would stick to a diet voluntarily, not what happens when they limit a macronutrient.
Participants were assigned either LC or LF. I wonder if the outcome would have been different if they had ‘willing’ LC participants, if they really wanted to be LC (and also, if they really wanted to be LF.) That the LC people had already increased their carbs to an average of 96.6 g per day by month 3 tells me they weren’t really compliant with LC WOE.
Well, for me it comes down to motivation.
Weight loss diets fail. They always fail. The number of people who stick to the diet and keep the weight off is miniscule.
That is going to be the result for 99% of people. The only question is how long it takes for the individual concerned to fall off the diet. And in the case of this study, the participants lost motivation before the study ended. Kind of predictable.
The only people who seem to stick to diets (of any kind) are the ones who have more motivation than normal. Scared of T2? Scared of a family history of heart problems? Scared of not fitting into that dress for daughter’s wedding? Determined to prove that irritating guy at work wrong? Determined to beat best friend to goal weight?
Those are motivations above and beyond ‘weight loss’, and those are what keep people plugging away.
Me? I am concerned that hyperinsulinemia will kill me long before diabetic complications do. Keeps me on track much better than a vague ‘I would like to lose weight’.
I have to partially disagree. We are still battling the old assumption that it requires personal fortitude to be successful at weight loss. If people can stick to Keto/LCHF until they are fat adapted, appetite and cravings can be greatly diminished. Not the case with low-fat diets. It was when I reached that point myself (fat adapted) that I realized, for the first time in my life, that I hadn’t been dealing with a character flaw.
I’d like to add that fasting can add a power boost to the appetite suppression, in my experience.
I don’t equate motivation with personal fortitude. It may work that way for some, but it certainly doesn’t work that way for me. In fact, when i’m really motivated, then the effort becomes less, not more.
As an example, some time last year i discovered that coffee raises my blood pressure. Now I LOVE coffee. Some mornings that cup was the reason i got out of bed. However, once i had clear evidence that my body gets raised bp for 3 days after a single cup, i haven’t tasted it once. No worries, no regret, no effort. Coffee just doesn’t figure in my world any more. No personal fortitude involved at all (except for a mild headache the first day).
You actually can ‘force feed’ people for an experiment. It just may not be very ethical. That said, it has been done to various degrees in the past, where, for instance, a group of people are kept in a controlled environment and provided food specific to them or their group during that time, and not permitted to eat or go anywhere to eat anything else. There were also the prisoner studies from decades ago where they, again, control what the prisoners can eat and upped their calories a lot to see what would happen.
I’m sure if you could pay people enough money, you could work this out. I’m sure you could find participants to stick to the program of something you force feed them for, say $60,000 for the year (more people if you up that). But, you multiply that by 600 people or so and you clearly need some deep funding, which is less likely if there isn’t a product incentive behind it or something.
But yea, this would have been more interesting if everyone made it to the end of 12 months actually on their diets, rather than not even making it 3 months. It’s also interesting though that they stayed below 100 g of carbs per day, as I believe that’s supposed to be closer to a “zone” diet or the diet used in Fat Head (which was noted on the podcast is not actually a keto or ‘very low carb’ diet).
This is an interesting study, but one thing that I want to point out is that it was low carb (at first) but not necessarily high fat. If the participants were encouraged to freely eat fat until they were full, I wonder if more would have stayed at the ketogenic low carb range. Also, the results looked largely based on weight loss. I would be very interested to see other markers (insulin resistance, HDL, trig, LDL particle size, CRP) to see what effect the diets had on them over the course of the year. That being said, the fact that whole natural foods were encouraged and highly processed junk foods were discouraged is most definitely a step in the right direction for folks looking to improve their overall health.
Have you heard of the Vermont Prison Overfeeding experiment? Worth a read.
Whenever I see a study with surprising results, I usually like to review the methodology and get as much raw numbers as I can to re-slice it. After all, as they say, numbers never lie, but liars use numbers.
Unfortunately, the full text of this study is behind a pay wall. However, why I am not comfortable with this study, is the very wide 95% confidence interval (From gaining 0.2kg to losing 1.6kg), to the difference in diet. Why this occurred is because there was a very wide variance WITHIN both groups. That means that with only 300 people in each group, there is a reasonable chance that even with a totally random distribution of people one group copping an overly large group of gainers landing in one group skewing results is high. Therefore, they need a wider margin to gain a 95% confidence interval.
With an average loss of 5.65kg, and 1.6kg of loss not being statistically significant, this means that about 28% of the loss cannot be attributed to the group they were assigned.
Yet the study also says that the amount of calories coming from carbs for each group is 48% (Low fat) vs 30% (Low carbs).
So what we’re saying is that we’re varying the source of calories by 18%, but any changes smaller than 28% need to be ignored. Does this not… raise any red flags? (There are other ways of expressing this. You could say that the experiment is "We are reducing the contribution carbs make to total calories by 37.5% and replacing them with fat, but then the aim would have to be to keep a stable weight for both groups - man, the different ways that you can rearrange the numbers coming out of this study is making my head spin.)
I believe (and bearing in mind, I’m no expert), that the correct conclusion isn’t “no difference”, but experiment cannot determine if there is a difference. As much as I hate the over used saying “The sample size is too small”, for this particular conclusion, the sample size IS too small. Groups of thousands would reduce the probability that one group would get all the gainers, and allow a much smaller confidence interval.
Have you heard of the Vermont Prison Overfeeding experiment? Worth a read.
Ummm… have you heard of the very next sentence after the part you quoted that was directly referencing that experiment (though I didn’t name it I guess)? Worth a read. (Not trying to be a jerk, just couldn’t resist that setup)
Ah, there have been a lot of prison experiments, wasn’t sure which one you were referring to. Vermont was just one I was specifically thinking of, because it was very detailed into monitoring what happened to the body with weight gain, why some people don’t gain weight, and was the first clue into the concept of set-point.
Edit - the other one I was thinking of was (Can’t find it again), they wanted to know if reducing inflammation, which is known to be linked with mood, could reduce aggressions in prisons. The answer was yes, but I don’t recall the details. I do believe reducing sugar was one of the actions they took.
I wouldn’t say that. The low-carb group saw a significant increase in high-density lipoprotein cholesterol (HDL-C) (+2.64, vs +0.40 mg/dL in the low-fat group) and greater reductions in triglycerides (-28.20, vs -9.95 mg/dL in the low-fat group).
On the face of it that carbohydrate restriction (to 100-130g/day) is inadequate to cause the liver to control glucose so I’m not surprised that they didn’t see a remission in metabolic disease. The fat restriction for the low fat arm isn’t adequate to meet rice diet levels … so it’s not surprising that neither arm had a significant drop in metabolic syndrome.
What I would like to see is the people in the low carb arm who really reduced their carbs below 50, and the people in the low far arm who restricted fat to less than 5% of calories. I predict both groups probably did have a significant decrease in metabolic syndrome. I suspect both groups would have had more weight loss than the other members of their cohort.
There are many issues with this study but what I find baffling is the non statistically significant difference of -5.3KG in the low fat group and the -6.0KG in the low carb group. Since when is a difference >10% not statistically significant? Even with 100g of carbohydrates and likely 3 meals and 2 snack (they were eating “healthy” after all) the low carb group out performed the low fat group in weight loss.